Diagnóstico tardío de la infección por el virus de la inmunodeficiencia humana en la Cohorte VACH (1997-2002)

Objective: To study the prevalence of delayed diagnosis of HIV infection and associated factors. Methods: A cross sectional study of patients included in the Spanish VACH cohort who had been diagnosed with HIV in- fection between 1997 and 2002 was performed. Delayed diag- nosis was defined as patients diagnosed with HIV infection and AIDS simultaneously or within the first month after the first positive serologic test, or those with a first CD4 + cell count below 200/ml. The epidemiological characteristics of these patients were compared with those of the remaining patients Results: Of 2,820 new cases of HIV infection, delayed diag- nosis was found in 506 (18%). These patients differed from the remaining patients in their lower mean age and higher HIV viral load, as well as in their distribution by sex (higher pro- portion of males), occupational status, history of incarceration in prison, and HIV-risk transmission group. The median sur- vival during follow-up was significantly lower among AIDS pa- tients with a delayed diagnosis. Conclusions: Delayed diagnosis remains a cause for con- cern in our environment, due to its magnitude and its asso- ciation with mortality. Some epidemiological characteristics pro- vide clues to guide future programs directed at increasing information and improving prevention.